Provider Demographics
NPI:1508934597
Name:DAHLMANN, KATHLEEN ANNA (MD)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:ANNA
Last Name:DAHLMANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 160
Mailing Address - Street 2:
Mailing Address - City:SILOAM SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72761
Mailing Address - Country:US
Mailing Address - Phone:918-326-4983
Mailing Address - Fax:918-326-4983
Practice Address - Street 1:101 W UNIVERSITY ST
Practice Address - Street 2:BOX 160
Practice Address - City:SILOAM SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72761-2663
Practice Address - Country:US
Practice Address - Phone:918-326-4983
Practice Address - Fax:918-326-4983
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK17988208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK23173OtherOBNDD
OK23173OtherOBNDD